Completion thyroidectomy for thyroid cancer

Whether thyroid re-operations are associated with an increased complication risk is controversial. The aim of this study was to perform a retrospective analysis of patients undergoing re-operative surgery of the thyroid. We analyzed the safety and the impact of delay on complications before undertaking radicalization thyroidectomy.

From January 1996 to July 2002, 150 consecutive patients with thyroid cancer were treated in our institution. A total of 62 patients underwent completion thyroidectomy. Twenty-seven had undergone their initial operation in our centre. Medical and pathologic data were obtained retropectively.

Pathological examination of the specimen after completion surgery revealed malignancy in a total of 35% of 62 patients. The time interval between initial surgery and completion thyroidectomy ranged from 5 days to 24 months (mean 3.1 months). Complications after re-operation were transient recurrent nerve injury in 1.6%, transient hypoparathyroidism in 4.8%, permanent hypoparathyroidism in 1.6% and chylous discharge in 1.6% of the patients. There was no significant difference between complication rates in patients operated on within 90 days or those operated on after this period (p > 0.05).

This study suggests that completion thyroidectomy is safe in the hands of experienced endocrine surgeons and the timing of re-operation has no impact on the development of complications.